Biography/Disclosures
Biography: Dr. Durrie is the founder of Durrie Vision, a world-class surgery center. He has performed over 50,000 refractive procedures in his career. Dr. Durrie is chairman of the board of iOR Partners, a company that provides consultation, development and management for office-based surgery suites.

For more information: Visit iOR Partners’ website at https://iorpartners.com/

Disclosures: Durrie reports he is a consultant for Alcon and Johnson & Johnson and is an investor in and chairman of the board for iOR Partners.
July 07, 2020
2 min read
Save

BLOG: Is office-based cataract surgery safe?

Biography/Disclosures
Biography: Dr. Durrie is the founder of Durrie Vision, a world-class surgery center. He has performed over 50,000 refractive procedures in his career. Dr. Durrie is chairman of the board of iOR Partners, a company that provides consultation, development and management for office-based surgery suites.

For more information: Visit iOR Partners’ website at https://iorpartners.com/

Disclosures: Durrie reports he is a consultant for Alcon and Johnson & Johnson and is an investor in and chairman of the board for iOR Partners.
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

The No. 1 question I get asked when it comes to office-based surgery is whether it is safe. When cataract surgery transitioned from the hospital to the ASC in the ’80s, the same concerns over safety existed.

Now, we don’t think twice about the safety standards of an ASC. I believe that 10 years from now, we will not give a second thought about the safety of office-based surgery (OBS). In this blog, I will address the top safety concerns regarding office-based cataract surgery.

Does office-based cataract surgery take place in a procedure room?

Daniel Durrie, MD

No. It is a common misperception that OBS is done in a clean room or a procedure room. Office-based surgery is any surgical or invasive procedure performed by a licensed physician in an operating room within the physician’s practice. OBS utilizes the same standard of care as an ASC or hospital and is accredited by the same national organizations including the Joint Commission, the Accreditation Association for Ambulatory Health Care or the American Association for Accreditation of Ambulatory Surgery Facilities.

What type of ophthalmic procedures are common in OBS?

Common ophthalmic OBS procedures include basic cataract surgery, refractive cataract surgery, refractive lens exchange, ICL implantation, various oculoplastics, MIGS and other lens-based procedures.

What are the clinical outcomes of OBS cataract surgery?

Office-based surgery provides safe and effective outcomes that are comparable to those performed in an ASC. The largest U.S. retrospective study (Office-Based Cataract Surgery: Population Health Outcomes Study) of 21,501 cataract surgeries (13,507 patients, age 72.6 ± 9.6 years) conducted in the Denver metropolitan area Kaiser office from 2011 to 2014 found that OBS efficacy outcomes were consistently excellent, with a safety profile expected of minimally invasive cataract procedures performed in ASCs and hospital outpatient departments.

As chairman of the board for iOR Partners, a company that provides consultation, development and management for OBS suites, we have seen similar outcomes. In more than 5,000 procedures performed in iOR facilities, our safety profile is consistently as good as or better than those in the Kaiser study.

What type of anesthesia is used?

Ophthalmic OBS can utilize either Class A (oral and topical) or Class B (IV sedation). Most OBS cases are performed under Class A level anesthesia and don’t require any additional patient monitoring or staff.

What about patients with comorbidities?

Comorbidities can be assessed on a case-by-case basis. Surgeons can take patients with comorbidities to the ASC. However, the surgeons we work with at iOR Partners become more comfortable over time with bringing these patients to OBS. In the case of a significant comorbidity in which additional equipment or an anesthesia team is needed, then the ASC is a viable backup.

PAGE BREAK

In addition to the points above, an ophthalmologist’s office can better control the patient flow for social distancing and minimize the exposure between patient and staff in the era of COVID. The bottom line is that each transition to a new setting is disruptive and raises concerns over safety. Office-based surgery is gaining momentum as the new standard of care for cataract surgery as the ophthalmic community recognizes that OBS facilities adhere to the highest safety standards and protocols.